Autonomous Guidewire Navigation for Robot-assisted Endovascular Interventions: A Knowledge-Driven Visual Guidance Approach

Autonomous robots for endovascular interventions hold significant potential to enhance procedural safety and reliability by navigating guidewires with precision, minimizing human error, and reducing surgical time. However, existing methods of guidewire navigation rely on manual demonstration data and have a suboptimal success rate. In this work, we propose a knowledge-driven visual guidance (KVG) method that leverages available visual information from interventional imaging to facilitate guidewire navigation. Our approach integrates image segmentation and detection techniques to extract surgical knowledge, including vascular maps and guidewire positions. We introduce BDA-star, a novel path planning algorithm with boundary distance constraints, to optimize trajectory planning for guidewire navigation. To validate the method, we developed the KVD-Reinforcement Learning environment, where observations consist of real-time guidewire feeding images highlighting the guidewire tip position and the planned path. We proposed a reward function based on the distances from both the guidewire tip to the planned path and the target to evaluate the agent's actions.Additionally, to address stability issues and slow convergence rates associated with direct learning from raw pixels, we incorporated a pre-trained convolutional neural network into the policy network for feature extraction. Experiments conducted on the aortic simulation autonomous guidewire navigation platform demonstrated that the proposed method, targeting the left subclavian artery, left carotid artery and the brachiocephalic artery, achieved a 100\% guidewire navigation success rate, along with reduced movement and retraction distances and trajectories tend to the center of the vessels.